Review
Copyright ©The Author(s) 2015.
World J Orthop. Mar 18, 2015; 6(2): 202-210
Published online Mar 18, 2015. doi: 10.5312/wjo.v6.i2.202
Figure 4
Figure 4 Sixty-four-year-old woman underwent total knee arthroplasty of the right knee and developed a chronic recurrent infection with loss of anterior soft tissue. The infection was treated and the knee was fused, but she developed limb length discrepancy (LLD) and nonunion of the right knee. She underwent resection of the nonunion, implantation of bone graft and bone morphogenetic protein-2, and gradual lengthening for the LLD. Proximal tibial and fibular osteotomies were performed, and external fixation was applied to the tibia. The antibiotic cement-coated rod was not removed. A: Preoperative anteroposterior view full length standing radiograph obtained at the time of nonunion and prior to lengthening; B: Anteroposterior view radiograph obtained during the distraction stage of treatment. Note that the distal fibula was captured with an anteromedial to anterolateral half-pin; C: Anteroposterior view full length standing radiograph obtained after the distraction stage of treatment was completed; D: Anteroposterior view full length standing radiograph obtained after external fixation removal and insertion of interlocking screws; E and F: Anteroposterior (E) and lateral (F) view full length standing radiographs obtained 12 mo after external fixation was removed. Note the complete and total regenerate healing at the level of the proximal tibia (reprinted with permission from the Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore).